By Dr David Laing Dawson
Stigma can be defined as “a set of negative and often unfair beliefs that a society or group of people have about something”.
‘Beliefs’ is the operative word here. When we are talking about the stigma of mental illness we are referring to the lingering effects of beliefs that date back hundreds of years, when it was commonly thought that mental illness, or the particularly odd, delusional behaviour of any one person, could be caused by that person having engaged in immoral behaviour, insufficiently honouring God, being in the throes of satanic worship, or actually housing the devil in some fashion.
Well, then the enlightenment came along, followed by science and modern medicine.
I assume in Canada today, few would ascribe to any of the beliefs in my second paragraph, but the attitudes may persist, with thoughts of immorality or devil possession being replaced by something like “weakness”, “not trying hard enough”.
How do we overcome these persistent attitudes? And are they really that important?
Our journey with cancer from 1950 to the present is instructive. Much of the stigma surrounding cancer has been conquered, subdued. But this did not happen because of Government or industry sponsored campaigns to diminish stigma. It did not happen because we promoted programs such as “Let’s Talk”, or “Moving Organ Health Forward”, invented new euphemisms like “cellular health issues”, or developed toll free hot lines for people to call if they were experiencing “cellular decline”. In fact, before about 1965, doctors did not use the word “cancer” in conversation with staff, families, and patients. Rather they used words of Latin and Greek origin that contained the soothing syllables of “neo” and “plasm”.
Today we talk openly of cancer. Cancer of various body parts, treatment of these cancers, treatment within institutions named “Cancer Centers”. As I have written before: Terry Fox did not run halfway across Canada to raise money for “Bone Health Issues.”
In contrast, with mental illnesses, we have been busy the past few decades developing new euphemisms, avoiding the words illness, mental illness, schizophrenia, psychosis, all in the mistaken belief that if we hide from reality, cover it up with gloss and good intentions, hide from it with privacy laws and secrecy, pretend that these illnesses are just extensions of “normal”, or expressions of “neurodiversity”, they will miraculously improve.
A unique experiment has been taking place in Canada the last few months. Instead of hiding behind shame, stigma, privacy, and euphemisms, one family has openly acknowledged, and publicly reached out for help, for an adult son and family member who is mentally ill, who suffers from a psychosis, and who became another homeless wanderer in Toronto. And it seems hundreds of people responded. Not with the fear and avoidance that stigma should engender, but with compassion, care, support. With good results so far, despite the failings of our mental health laws and faltering institutions.
So yes, “Lets Talk”, but lets talk reality, enlightened modern medicine, illness, and treatment of illness. Let’s name those illnesses and their symptoms. Without euphemisms and secrecy. Without pie in the sky “models”, without phony unscientific remedies.
And lets fund the professional resources needed to treat serious mental/brain illness, not just peer support, coffee urns in “crisis hubs”, three digit hot lines, and anti-stigma campaigns.